Tucson Medical Center routinely achieves critical treatment timelines for patients that give them the best outcomes after heart attack or stroke.

“On behalf of the American Heart Association and the American Stroke Association, I thank you for your commitment,” said Ron Loomis, Jr., the senior regional director for quality and systems improvement for the associations, in presenting an award to the TMC team.

TMC earned the Get with the Guidelines Stroke Gold Plus Quality Achievement Award by meeting specific quality metrics for the diagnosis and treatment of stroke within a designated period that are scientifically proven to reduce death and disability for stroke patients.

TMC additionally received the Target: Stroke Elite Honor Roll award, which reduces time between when a patient suffering from ischemic stroke arrives at the hospital and when treatment starts with a clot-busting drug. Ischemic strokes occur when the arteries to the brain narrow or become blocked, reducing blood flow. We are the only hospital in Southern Arizona with this top level designation.

Stroke is the fifth leading cause of death in the U.S. and a leading cause of disability. “Research has shown that hospitals adhering to these evidence-based guidelines often see improved outcomes and fewer readmissions,” Loomis said.

Dr. David Teeple, the medical director for TMC’s stroke program, said the program has been growing in effectiveness for the last 10 years, to the point that TMC has for many years been recognized for putting proven knowledge and guidelines to work on a daily basis.

“It’s ingrained in what we do here now,” he told the team, “but don’t underestimate the hard work you all do to achieve these guidelines. I’m incredibly grateful and our patients are incredibly grateful.”

Tucson Medical Center clinical staff will tell you that simply helping people when perhaps they need it most is all the reward they need in their noble profession. So when a patient comes back to say ‘thank you’ following an extraordinary recovery, it is instantly uplifting for them.

Sandy Goodsite recently came back to say ‘thank you,’ and hug the people who she credits with not only saving her life, but also giving her the quality of life she essentially had before April 22, 2014.

That’s when Goodsite, 72, suffered a significant stroke. She was rushed to TMC and received a clot-busting drug called tPA just 22 minutes after hitting the doors of the Emergency Department (ED), one of the fastest response times in the city. You can read about her incredible ordeal here.

Goodsite is now about 95 percent recovered, as she continues speech and occupational therapies. She and her husband, semi-retired pediatrician Dr. Ron Goodsite, felt compelled to come back and personally thank those who were working the day she was brought in via ambulance. They were armed with thank you notes, addressed to every staff member who helped care for her. As the Goodsites were ready to make their way to their first stop, they were greeted in the lobby by two members of the Neuro Red team, which responds to stroke victims. “Talking to her, and seeing how well she’s doing reminds me why we do what we do,” said Shannon Bachman, RN.

The Goodsites headed inside TMC’s ED where staff was just as touched that Sandy is not only doing so well, but also took the time to come back. “It is so fantastic that she came back because it’s typically very rare that we get to see a patient after they leave the ED,” said Heather Williams, ED clinical nurse lead. Melissa Ritchey, director of TMC’s ED, echoed that sentiment. “It reminds us why we come to work each day. I’m so grateful that she came back to say thanks. You only need to hear that one time to remember each and every time why we do what we do.”

Next stop: TMC’s Intensive Care Unit where Goodsite was greeted and immediately recognized by staff who hadn’t seen her since her two-day stay there in April. “It’s so nice to see you up walking and talking!” said Jenny Tuttle, ICU clinical nurse lead. “We always appreciate when people take the time to come back because we see them in a bed, in an acute setting. It’s not very often we get to see the progress they’ve made, so it means a lot to us to see her doing so well,” she said.

On the neurological unit, clinical nurse lead Nancy Box said she was in awe. “It’s so neat to see somebody come back and look so good because we rarely get to see the end result. When they leave here, they typically have some sort of deficit, so it’s amazing to see Sandy talking and moving so well, and how her hard work during rehabilitation has paid off.”

The Goodsites are also catering a savory dinner for the three departments involved in Sandy’s care. “We wanted to provide a little something for them – to do more than just say thank you,” she said. But they realize that her incredible care started with the lightning fast response by Tucson Fire paramedics Bill Nielson and Robert Smith. The Goodsites paid the boys in blue at station No. 7 a visit, and catered a dinner for the crew that was covered by the Arizona Daily Star and KGUN 9 On Your Side.

*Special thank you to TMC volunteer Mary Goeke who stayed late to accommodate the Goodsite’s visit. Goeke helped transport the Goodsites from the different departments at TMC and said she felt honored to be a part of something so special.

That’s how Dr. Ron Goodsite described his wife’s stroke, and subsequent response that led to her extraordinary recovery. Serendipity that everything fell into place as it did. “Sandy exhibits what an ideal patient’s response should be,” he said.

It happened April 22, 2014.

Sandy GoodsiteTMC Stroke Survivor

Sandy Goodsite, 72, stopped by her medical management company for just a few minutes to get some things done when an employee noticed that she was unable to move, and staring into space. She realized something wasn’t right, and alerted Sandy’s daughter, who was in the next room. Sandy’s right side was beginning to droop. Her daughter immediately called 911. Within minutes, the office was full of firemen, and stunned employees watched as Sandy was loaded into an ambulance.

Longtime Tucson pediatrician Dr. Goodsite is now semi-retired, and works in the imaging department at TMC for Children. He was just finishing up his shift when his phone rang. It was his daughter telling him Mom was on her way in via ambulance. “It was really scary,” he said. “It can happen to any of us at anytime, and it can happen when you least expect it. When you have something like this that affects a loved one, it’s frightening.”

Sandy’s risk factors were well controlled. She had no symptoms. And absolutely no warning signs.

Emergency Department staff triggered a hospital-wide alert called Neuro Red in which a team of people immediately report to the emergency room, including the rapid response nurse, house supervisor, lab technicians, and the neurologist on-call. In Sandy’s case, neurology resident Dr. Muhammad Kahn responded. Radiology was put on alert, and pharmacy was put on stand-by.

Sandy’s stroke affected a significantportion of her brain.

As soon as Sandy hit TMC’s emergency department, her blood was drawn and a brain scan was performed. She had suffered an ischemic stroke, in which a blood clot broke off and traveled to the left side of her brain – the portion that controls speech and language. The stroke was significant. CT scans show the clot affected a baseball-sized portion of her brain. The right side of her body was completely weak, as is typical with stroke victims.

TMC Neurologist and Stroke Director Dr. David Teeple administered a drug called tissue plasminogen activator, or tPA. It’s approved by the FDA for treatment of ischemic stroke up to three hours after stroke, and works by dissolving the blood clot.

Ischemic stroke patients should get tPA within 60 minutes of hitting the emergency room. Sandy received it 22 minutes after she arrived at TMC, one of the fastest times in the city.

Dr. David TeepleTMC Neurologist & Stroke Director

“With stroke, time really is of the essence,” said Dr. Teeple. “Every minute, a stroke patient loses about 2 million brain cells. Every hour, they lose 120 million brain cells. The sooner you give tPA after the onset of stroke symptoms, the more effective it’s going to be. That first hour is really the golden hour where we can eliminate a lot of the brain damage caused by stroke if we administer tPA quickly. For Mrs. Goodsite to receive tPA 22 minutes after hitting the emergency room door is absolutely incredible.”

Six hours after tPA was administered, Sandy’s motor deficiency had disappeared. Sandy was in TMC’s intensive care unit for two days, followed by two more days in the neurological unit. Initially, she was unable to write. Her words all ran together. She mixed up right, left, up and down – a very common symptom of stroke. Sandy spent the next ten days at HealthSouth where she made big strides with her rehabilitation.

Each day, she started doing a little bit more. It didn’t take long for her ability to write and speak to come back. “My husband used to laugh because of my ability to multitask,” she said. “I’d work on three things at once, and it would drive him batty.” She’s working on being able to multitask once again, and also how to focus. She gets easily distracted, but did not lose any intellect during the stroke.

Dr. Ron & Sandy Goodsite

Dr. Goodsite finds himself wondering what would have happened if anything went differently that day. What if Sandy would have suffered that stroke while driving? What if those firemen were on another call, and it took them longer to respond? What if TMC wasn’t a designated Primary Stroke Center, and didn’t have the Neuro Red team in place? “We have a strong faith in God, and we believe we had help from above. We felt that someone was looking out for us, and especially looking out for Sandy,” said Dr. Goodsite.

Dr. Teeple said Sandy’s remarkable recovery is extremely gratifying from a physician standpoint. “This is the culmination of everything TMC, the city, and EMS have been working so hard on for the past five years. Since TMC is a Primary Stroke Center, we have the foundation in place to be fully prepared for these patients before they even get here. Everyone in every department that was involved – did the right thing, and worked together to get this result.”

“My appreciation of TMC has really gone up 1,000 percent since I’m now a person who has experienced this firsthand,” Dr. Goodsite concurred. “That day, I was at TMC – not as a physician, but as a husband. I am completely amazed at how the brain is able to recover once tPA is administered. But beyond that medication – the Neuro Red team TMC has in place – is incredible. As soon as Sandy hit the doors at TMC, she was immediately taken to the exam room and then her brain was scanned, and the tPA was administered. The response was remarkable.”

Doctors are still trying to find out exactly where the clot came from in Sandy’s body. She’s about 95 percent recovered, and making incredible strides with the occupational and speech therapy she is receiving twice a week. She has what’s known as expressive aphasia – similar to when you have a thought or a word “on the tip of your tongue.” It’s in your head, but you’re just having a hard time retrieving it. Day by day, however, she’s making big improvements.

The Goodsites have plans to formally thank the medics and TMC staff members who did everything right that day, which aided in her quick recovery. Dr. Goodsite said, “I can’t wait for Sandy to walk in, and see these people, and say ‘Thank you.’”

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About TMC

Tucson Medical Center, licensed at more than 600 beds, has been Tucson’s locally governed nonprofit regional hospital for more than 70 years.

TMC is Southern Arizona’s leading provider for emergency care and pediatric care (including Tucson’s first Pediatric Emergency Department), with top-notch intensive care units for adults, children and newborns.